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Tuesday, April 15, 2008

last dance

There's something about nearing the end of your residency that changes things completely. It's like suddenly, you realize that this is it, this is your last chance to learn all this stuff under such close supervision before being trusted to do it alone, so if you don't get a chance to learn it in the next few months, you're on your own. Nights on call suddenly become much less about getting through the next few hours and more about getting your hands on everything. Yes, I want to do that. Let me take care of that. Epidural in Room 6? Yes, I'll do it. Don't you know I only have two and a half weeks left before I may never do Obstetric or Pediatric anesthesia again? Crikey. This is like the bachelor party of my career. Bring on the strippers!

Not to jinx myself, but I seem to have rid myself of the whammy, mostly all in one night last Thursday when I did ten epidurals in a row and didn't even have time to think about screwing up. It was really just one epidural fairly early in the night that found its way into the epidural space seemingly by itself, and after that I stopped second-guessing myself so much and trusting my hands. Also, I realized that I proably have to stop drinking coffee in the morning, or at least start to drink less, because it causes my hands to shake, and screws up my fine motor skills, at least until the caffeine wears off mid-morning. Actually, I'm not sure if it's just my fine motor skills, it seems at times like the jittery coffee feeling robs me of my ability to accelerate and decelerate with any degree of sensitivity--I end up working in this jerky way, like a student driver putting on the brakes every fifty feet. Very disconcerting. I know I'm not the only one who feels this way--I know that Joe doesn't drink coffee on the mornings that he's operating, and for him, that's saying a lot. He would mainline Peet's coffee if given the chance, but, barring that option, is just as pleased with a flagon of Starbucks' sludgiest sludge three or four times a day.

Strangely, it's only the coffee from those sidewalk coffee carts that causes this autonomic hyperdrive on me. A tall cup of that Dunkin' Donuts brew seems to have none of these coffee-related effects at all, aside from its diuretic features. So either Dunkin' Donuts coffee is one weak brew, or the roadside coffee is steeped in cocaine. Take your pick.